| NPI | 1104069269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: CA A107290) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A107290) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A107290) | |
| Enumeration Date | 2009-04-19 |
| Last Update Date | 2020-11-17 |