| NPI | 1801158852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 71187) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R9529) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2019-08-06 |