| NPI | 1063675890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D87116) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD434830) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 253372) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2019-05-23 |