| NPI | 1710949920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 42389) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 46040) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2021-03-08 |