| NPI | 1790774180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO 28226) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: CO 28226) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2021-02-23 |