| NPI | 1932789773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0116041365) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2024-00813) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2025-06-30 |