| NPI | 1912359506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 320489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 28836) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2024-06-14 |