| NPI | 1922386085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME143637) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT199883) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 077112) | |
| Enumeration Date | 2011-07-23 |
| Last Update Date | 2020-10-01 |