| NPI | 1316109739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MT 29006) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R70152) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2024-04-05 |