NPI | 1811558265 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME172735) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN35146) |
Enumeration Date | 2019-06-26 |
Last Update Date | 2025-06-13 |