| NPI | 1417222548 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 58536)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 62059)  | 
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 62059)  | |
| Enumeration Date | 2012-03-22 | 
| Last Update Date | 2021-05-03 |