| NPI | 1972591683 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME00061671) | 
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME00061671) | 
| Enumeration Date | 2005-10-07 | 
| Last Update Date | 2014-07-19 |