| NPI | 1992920581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A104752) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP00087) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-07-15 |