| NPI | 1700262862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.067395) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NH 22097) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2022-07-28 |