| NPI | 1114453016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA 170563) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA 170563) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2025-03-07 |