| NPI | 1760747216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PR 19027) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 19027) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2019-06-19 |