| NPI | 1730250093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME144440) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101240269) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-07-02 |