| NPI | 1740466564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2011-00902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01064678A) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2021-03-31 |