| NPI | 1972846343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 66404) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: GA 76298) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2019-12-19 |