| NPI | 1346669983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2022001802) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101259139) |
| 207R00000X Internal Medicine (Licence: VA 0101259136) | |
| 208D00000X General Practice (Licence: VA 0101259136) | |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2024-05-02 |