| NPI | 1629232913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KS 04-40535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT189101) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD445914) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2023-08-25 |