| NPI | 1881006518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 295122) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD16161) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT219393) | |
| 207R00000X Internal Medicine (Licence: RI LP 03157) | |
| 208000000X Pediatrics (Licence: RI LP 03157) | |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2026-01-23 |