| NPI | 1023690104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME166183) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 1265971691) |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2024-05-24 |