| NPI | 1245593474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2016-00511) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125061353) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2016-04-22 |