| NPI | 1134561632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD465892) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT204361) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2021-03-04 |