| NPI | 1255315958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 79524) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: ME MD29753) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME73222) | |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2025-12-12 |