| NPI | 1023456324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: UT 11316576-1204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101022500) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2021-11-18 |