| NPI | 1174907737 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 35C.001571)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 33637)  | 
| Enumeration Date | 2015-07-14 | 
| Last Update Date | 2025-02-21 |