| NPI | 1235586702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 80020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R75583) |
| Enumeration Date | 2016-05-15 |
| Last Update Date | 2022-08-04 |