| NPI | 1992264782 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KS 94-11158) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 0) | 
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2025028927) | |
| Enumeration Date | 2019-03-19 | 
| Last Update Date | 2025-08-07 |