| NPI | 1659892511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: NE 2456) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS16939) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2023-08-11 |