| NPI | 1972990182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: MN 61388) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 61388) |
| Enumeration Date | 2015-04-26 |
| Last Update Date | 2022-07-14 |