| NPI | 1629206750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SD 10248) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 788) |
| Enumeration Date | 2009-06-27 |
| Last Update Date | 2025-06-24 |