| NPI | 1710398128 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 5101021133) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101021133) | 
| Enumeration Date | 2014-05-20 | 
| Last Update Date | 2022-07-21 |