| NPI | 1992374300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS023850) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA OT020822) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-03-04 |