| NPI | 1962479642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R7C50) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO MDR7C50) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2016-10-19 |