| NPI | 1336120906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME63365) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME63365) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2019-12-09 |