| NPI | 1518131168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 103800) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO #not received yet) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: ME MD19329) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2025-10-07 |