| NPI | 1013323831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 277056) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 275825) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-08-18 |