| NPI | 1154983385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: LA 330826) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 330826) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2025-07-22 |