| NPI | 1669176301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 82548) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R80072) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2026-05-29 |