| NPI | 1225423148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA 173950) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 123456789) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-10-04 |