| NPI | 1972509081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301085395) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301085395) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2012-01-10 |