NPI | 1831771542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 80093) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116035128) |
208000000X Pediatrics (Licence: VA 0116035128) | |
Enumeration Date | 2021-04-22 |
Last Update Date | 2025-06-20 |