| NPI | 1407979032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: LA 335796) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2014-02170) |
| 207R00000X Internal Medicine (Licence: MI EMC0009652) | |
| 207RH0000X Internal Medicine, Hematology (Licence: MI EMC0009652) | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: MI EMC0009652) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 30801) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2026-07-14 |