| NPI | 1205154689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: LA 308638) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0075419) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2023-03-11 |