| NPI | 1558743187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 88687) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015019423) |
| 207R00000X Internal Medicine (Licence: MO 2015019928) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 010002) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2021-07-04 |