| NPI | 1497751390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E3199) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR E3199) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AR E3199) | |
| 173000000X Legal Medicine (Licence: AR E3199) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2024-01-11 |