| NPI | 1639611122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: OH 57.245303) |
| Additional Taxonomies | 207RH0000X Internal Medicine Hematology (Licence: TX BP10055493) |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2018-07-30 |