| NPI | 1619361797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MA 29734) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 29734) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2015-03-26 |