| NPI | 1306258090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2025028950) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-42379) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2025-07-29 |