| NPI | 1891256780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 19472) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: UT 13361583-1204) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2023-08-21 |