| NPI | 1558700633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2020-00885) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2020-00885) |
| 207R00000X Internal Medicine (Licence: VA 0101257992) | |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2023-07-31 |