| NPI | 1942235429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 48051) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO 38639) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: HI MD-20983) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2021-04-22 |