| NPI | 1104846765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 253635) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 39677) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2021-02-25 |