| NPI | 1104204510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MN 60760) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 60760) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 60760) | |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2021-06-24 |