| NPI | 1710218011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 54325) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036124054) |
| 207R00000X Internal Medicine (Licence: WI 54325) | |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2020-10-01 |