| NPI | 1952757684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A180251) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 60480) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2022-08-03 |