| NPI | 1114289519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0102205542) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 1574) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2021-05-21 |