| NPI | 1124551619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME170742) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 308040) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101282878) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2024-11-22 |