| NPI | 1124119573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 081524) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 48689) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME105231) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-26 |