| NPI | 1669679809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WV 24149) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2024-02971) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WV 24149) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2024-10-29 |