| NPI | 1811280431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO 55429) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 55429) |
| 207P00000X Emergency Medicine (Licence: TX N9365) | |
| 207R00000X Internal Medicine (Licence: MI 4301099957) | |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2019-07-19 |