| NPI | 1720548183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MO 2025010867) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: KS 04-50917) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2025-10-06 |