| NPI | 1154982999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 68707) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D93814) |
| 207R00000X Internal Medicine (Licence: MO 2019021213) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2023-07-06 |