| NPI | 1962854463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D93599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267831) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4351044066) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2022-04-28 |