| NPI | 1700563269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME179043) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2023020829) |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2026-06-22 |