| NPI | 1225441017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: ME MD23603) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03237) |
| 207R00000X Internal Medicine (Licence: OH 35.131702) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2022-07-21 |