| NPI | 1427466655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: WI 67487) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT206839) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2023-12-28 |