| NPI | 1821387135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME126590) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 126590) |
| 207R00000X Internal Medicine (Licence: KY 46858) | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2022-09-14 |