| NPI | 1952530677 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 36252) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 5899) | 
| Enumeration Date | 2009-07-02 | 
| Last Update Date | 2025-04-01 |