| NPI | 1679810089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2021039829) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO 2021039829) |
| 207R00000X Internal Medicine (Licence: MO 2021039829) | |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2026-06-08 |