| NPI | 1962864538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MN 73573) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 312520) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2023-06-29 |