| NPI | 1740714419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 35432) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 64095) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2024-03-14 |