| NPI | 1609455245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA OT024075) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.016951) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2025-06-27 |