| NPI | 1831454149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE CP1571) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO CDRH.0066986) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 258572) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO DR.0066986) | |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2025-09-19 |