| NPI | 1568441368 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AR C5955)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: AR C5955)  | 
| Enumeration Date | 2006-01-11 | 
| Last Update Date | 2025-03-04 |