| NPI | 1831202480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 37407) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 104225) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2004-00168) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2021-05-12 |