| NPI | 1851603674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 47422) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NV 22291) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: ID MC-2460) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX T6765) | |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2026-07-07 |