| NPI | 1699968503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A119729) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 25181) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2024-02-10 |