| NPI | 1811209380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME131283) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01072570A) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2019-04-05 |