| NPI | 1689156622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2025-01794) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C014962) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2025-12-02 |