| NPI | 1346621703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 37656) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL37656) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 37656) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2022-07-28 |