| NPI | 1720217714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO CDR.0001190) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 60902) |
| 207R00000X Internal Medicine (Licence: ND 13567) | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2021-07-02 |