| NPI | 1659377950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 37722) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO CDR.0005430) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2025-08-20 |