| NPI | 1942566567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME136305) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: LA MD.207905) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2020-01-14 |