| NPI | 1912354366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 68854) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 6389) |
| 207RH0000X Internal Medicine, Hematology (Licence: OH 35.145753) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2024-01-23 |