| NPI | 1891832630 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MN 55304) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 044967) | 
| Enumeration Date | 2007-01-31 | 
| Last Update Date | 2020-08-14 |