| NPI | 1750819702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 45564) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-09166) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2023-06-01 |