| NPI | 1730587429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 76236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11814) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2024-10-21 |