| NPI | 1669121406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME163850) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN35738) |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2025-05-27 |