| NPI | 1669695615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PR 04421) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR Lic 04421) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2025-09-11 |