| NPI | 1164808168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2025-01562) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MS 28174) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2025-09-03 |