| NPI | 1962846196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME160693) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 78600) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL 160693) | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2025-06-30 |