| NPI | 1487304002 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 74714) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 32524) | 
| 207R00000X Internal Medicine (Licence: MN 74714) | |
| Enumeration Date | 2022-03-26 | 
| Last Update Date | 2025-06-16 |