| NPI | 1083912828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 303703) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: LA 303703) |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2021-10-21 |