| NPI | 1164681540 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 248977) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NJ 25MA08275000) | 
| Enumeration Date | 2008-06-02 | 
| Last Update Date | 2019-09-03 |