| NPI | 1679195697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 96867) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN30601) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME154269) | |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2026-08-31 |