| NPI | 1306341144 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 338533) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 338533) | 
| Enumeration Date | 2018-03-26 | 
| Last Update Date | 2025-09-10 |