| NPI | 1093093619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 82510) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 123669) |
| 207RH0000X Internal Medicine, Hematology (Licence: ND 14498) | |
| 207RH0000X Internal Medicine, Hematology (Licence: FL ME159209) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61116309) | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: ND 14498) | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: FL ME159209) | |
| Enumeration Date | 2011-07-31 |
| Last Update Date | 2023-09-19 |