| NPI | 1700205549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 65649) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 65649) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2024-03-12 |