| NPI | 1174936835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: FL ME149613) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD16442) |
| 207R00000X Internal Medicine (Licence: FL ME149613) | |
| 207RH0000X Internal Medicine, Hematology (Licence: FL ME149613) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: RI MD16442) | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2021-09-24 |