| 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 |