| NPI | 1184157539 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME161380) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 77942) | 
| Enumeration Date | 2017-04-04 | 
| Last Update Date | 2025-08-15 |