| NPI | 1801092705 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WV 24937) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01070849A) | 
| Enumeration Date | 2007-06-26 | 
| Last Update Date | 2020-02-05 |