| NPI | 1548644180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2022-00873) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2022-00873) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2023-05-04 |