| NPI | 1962501718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA C52285) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 75069) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2008-06-02 |