| NPI | 1063875227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD496322) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: MO 2022031957) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2026-07-23 |