| NPI | 1801156765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TN 53048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN17301) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2021-06-15 |