| NPI | 1164983748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: AZ 76282) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 31499) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2025-07-16 |