| NPI | 1972595668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME96227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 15819) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PR 15819) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2023-02-09 |