| NPI | 1215590864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME147491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN28527) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2022-07-01 |