| NPI | 1760918411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX V9660) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD470230) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2025-10-02 |