| NPI | 1700376308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD483376) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 69009) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2025-02-05 |