| NPI | 1801076633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A101414) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A101414) |
| 207RH0000X Internal Medicine, Hematology (Licence: CA A101414) | |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2015-09-17 |