| NPI | 1386107720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: TX V7872) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: NC 2023-01668) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2025-07-01 |