| NPI | 1629416409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine Hematology (Licence: NE 32587) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: NE 32587) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: WI 65153-20) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2020-12-03 |