| NPI | 1104321967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: SC MD85083) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC MD85083) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-03-14 |