| NPI | 1114956067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD053781L) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NJ 25MA06831800) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2022-04-28 |