| NPI | 1497954564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2023-00157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2007013140) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME120425) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2024-07-29 |