| NPI | 1053057463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: UT 14214224-1204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS20751) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2025-04-22 |