NPI | 1083137228 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: PA MD487789C) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN25732) |
207R00000X Internal Medicine (Licence: MS 28083) | |
Enumeration Date | 2017-07-19 |
Last Update Date | 2025-03-14 |