| NPI | 1609014695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX S1604) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: ME MD19661) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2021-09-08 |