| NPI | 1417487026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC LL51185) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2023-01607) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2023-07-31 |