| NPI | 1700269404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 89908) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 7538) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2022-01-06 |