| NPI | 1356606032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2020-02267) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2020-02267) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: NC 2020-02267) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2023-05-04 |