| NPI | 1588955843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 63950) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 63950) |
| 207U00000X Nuclear Medicine (Licence: WI 64292-20) | |
| 207R00000X Internal Medicine (Licence: WI 64292-20) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 64292-20) | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2023-08-17 |