| NPI | 1659788941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME154206) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-48323) |
| 207R00000X Internal Medicine (Licence: IL 036.156403) | |
| 207R00000X Internal Medicine (Licence: NC 2018-00483) | |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2022-04-06 |