| NPI | 1093192494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4351052144) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 27185) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2024-06-25 |