| NPI | 1669734083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME174976) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 38568) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2025-07-07 |