| NPI | 1750727764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD192595) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 58083) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2022-01-18 |