| NPI | 1255412664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A24222) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A24222) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2022-07-21 |