| NPI | 1811259096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 86536) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101264136) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT201305) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2021-09-29 |