| NPI | 1700980299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX M8506) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KS 04-30473) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2023-02-20 |