| NPI | 1386111599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025212) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 25212) |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2023-07-17 |