| NPI | 1164153292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA R-13349) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-8342) |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2025-02-08 |