| NPI | 1790926228 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 251320) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD13771) | 
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: RI MD13771) | |
| Enumeration Date | 2009-03-12 | 
| Last Update Date | 2025-03-09 |