| NPI | 1174051601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 1013974) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL41097) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC RTL20-0027) | |
| Enumeration Date | 2017-05-29 |
| Last Update Date | 2023-06-01 |