| NPI | 1275141673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL TRN37111) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT220699) |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2026-06-23 |