| NPI | 1801174354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 66893) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125059158) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2020-01-09 |