| NPI | 1669993739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 68198) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 68198) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2026-06-02 |