| NPI | 1508111527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2018-01082) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT200805) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2022-08-16 |