| NPI | 1578851572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 49297) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-00568) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME156097) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2023-09-13 |