| NPI | 1609995703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: KY 45259) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301086360) |
| 207R00000X Internal Medicine (Licence: KY 45259) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-10-19 |