| NPI | 1144529769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: WV 29029) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 0420012849) |
| 207RH0000X Internal Medicine, Hematology (Licence: MD D0097056) | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2022-04-08 |