| NPI | 1992155949 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D0092324)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018033140)  | 
| 208D00000X General Practice (Licence: MO 2018033140)  | |
| Enumeration Date | 2016-06-20 | 
| Last Update Date | 2023-05-17 |