| NPI | 1023698388 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A185173) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 289102) | 
| Enumeration Date | 2021-04-12 | 
| Last Update Date | 2023-06-23 |