| NPI | 1780098756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 75019) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 075019) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2024-01-10 |