| NPI | 1164643300 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101058298)  | 
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: PA MD437637)  | 
| Enumeration Date | 2007-05-02 | 
| Last Update Date | 2022-07-21 |