| NPI | 1255683652 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL Me129886) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 280991) | 
| Enumeration Date | 2012-10-09 | 
| Last Update Date | 2022-06-22 |