| NPI | 1720390735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 1-100280) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-100280) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2024-02-01 |