| NPI | 1801185137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME131401) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0077282) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2017-07-05 |