| NPI | 1407506983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101281005) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101281005) |
| Enumeration Date | 2022-03-27 |
| Last Update Date | 2025-07-20 |