| NPI | 1376823567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: IA 45840) |
| Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease (Licence: NY 60 280695) |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2021-01-13 |