| NPI | 1578903795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD482201) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 70463) |
| 207R00000X Internal Medicine (Licence: MI 4301102962) | |
| 207RH0000X Internal Medicine, Hematology (Licence: MN 70829) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2025-04-16 |