| NPI | 1063409688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NV 20944) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY C2194) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO R5H89) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2023-12-12 |