| NPI | 1164803573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 273455) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-263489) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2021-04-29 |