| NPI | 1154365252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301034288) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI EB034288) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-04-06 |