| NPI | 1770979007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101280991) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 309995) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2025-03-28 |