| NPI | 1063755072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 299563) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0058942) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2026-01-08 |