| NPI | 1447955133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0116038371) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2026-02251) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2026-06-26 |