| NPI | 1154619021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301510406) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA 44063) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 30205) | |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2024-03-05 |