| NPI | 1013545151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT227712) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30752) |
| 207R00000X Internal Medicine (Licence: MN 69713) | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2023-07-04 |