| NPI | 1013980903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: NY 136251) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NY 136251) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2022-03-25 |