| NPI | 1942594155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 40462) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 55320) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2021-01-20 |