| NPI | 1790913994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD176450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP01695) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 57041) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2024-05-16 |