| NPI | 1376808329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2021-01291) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2021-01291) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2025-09-25 |