| NPI | 1811384001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A144782) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 274554) |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2022-05-12 |