| NPI | 1255468534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301055087) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301055087) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2021-06-24 |