| NPI | 1346635679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: PA MD479403) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0091105) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: MD D0091105) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2023-02-15 |