NPI | 1265865968 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 46618) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R74151) |
207RH0003X Internal Medicine, Hematology & Oncology (Licence: OK 32219) | |
Enumeration Date | 2013-08-16 |
Last Update Date | 2023-08-29 |