| NPI | 1679573752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TN MD031458) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 36598) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2021-04-12 |