| NPI | 1366679177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD460506) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301092385) |
| 207R00000X Internal Medicine (Licence: PA MD460506) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2022-07-21 |