| NPI | 1912971300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine Hematology (Licence: CA 52229) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 52229) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2023-03-07 |