| NPI | 1659550309 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 52717)  | 
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: MN 52717)  | 
| Enumeration Date | 2007-10-30 | 
| Last Update Date | 2021-09-28 |