| NPI | 1154733103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD489804) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9408418) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AR E-12725) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2026-01-14 |