| NPI | 1114415585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2023-03166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2023-03166) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2025-08-18 |