| NPI | 1902801566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2019-01493) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101034547) |
| 207R00000X Internal Medicine (Licence: VA 0101034547) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101034547) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 109019) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2022-09-08 |