| NPI | 1609423557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2022019688) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT217973) |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2022-07-19 |