NPI | 1255746251 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY MT205788) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT205788) |
Enumeration Date | 2014-06-27 |
Last Update Date | 2018-12-13 |