| NPI | 1861474223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: PR 12702) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: FL ME121889) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2021-06-15 |