| NPI | 1770193054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NM MD2025-0883) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2020016713) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2026-04-24 |