| NPI | 1881012607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL 51449) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.130064) |
| 207R00000X Internal Medicine (Licence: FL TRN20360) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME154450) | |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2025-07-01 |