| NPI | 1174906010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NH 23160) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264217) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 264217) | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2023-06-13 |