| NPI | 1235543992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine Hematology (Licence: GA 103954) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R6120) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2025-04-08 |