| NPI | 1578826640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101277041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 34637) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NH 34637) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2025-05-05 |