| NPI | 1982989836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A118615) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A118615) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2018-11-19 |