| NPI | 1649831314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 105339) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151014083) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2025-09-10 |