| NPI | 1578656005 |
|---|---|
| Other Name | N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 98477) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 54506) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2025-07-18 |