| NPI | 1396949244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MT 23851) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 2294) |
| 207R00000X Internal Medicine (Licence: UT 7152644-1205) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2021-05-20 |