| NPI | 1174056121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AR E16209) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 10957053-1205) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2024-01-31 |