| NPI | 1699161901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 67421) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 67421-20) |
| 207R00000X Internal Medicine (Licence: WI 5892) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-06-07 |