| NPI | 1992789291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101245391) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 33401) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2012-09-04 |