| NPI | 1265562508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD33401) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: DC MD33401) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2025-12-09 |