| NPI | 1619228483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301109700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125062123) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2019-06-19 |