| NPI | 1912994872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: FL ME92759) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: TX L6068) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: WI 101548) | |
| 208000000X Pediatrics (Licence: MI 4301072567) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2024-03-15 |