| NPI | 1861876526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2026003890) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KS 04-52391) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA MD-48110) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2026-03-03 |