| NPI | 1689939993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2019005326) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP02565) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 259137) | |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2025-01-09 |