| NPI | 1790205169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX S5300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT213765) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2024-04-08 |