| NPI | 1992700926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 28455) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 207RH0003X) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2011-11-04 |