| NPI | 1861923633 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2020022760) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2020022760) | 
| Enumeration Date | 2017-03-23 | 
| Last Update Date | 2023-07-10 |