NPI | 1104356955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NJ 25MA11084600) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.071327) |
Enumeration Date | 2017-06-14 |
Last Update Date | 2024-09-05 |