| NPI | 1881844058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WV 27605) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 56468) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2022-04-05 |