| NPI | 1497767974 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 174400000X Specialist (Licence: NY 161928-1) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 161928-1) | 
| 207RH0000X Internal Medicine, Hematology (Licence: NY 161928-1) | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: NY 161928-1) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 161928-1) | |
| Enumeration Date | 2006-08-12 | 
| Last Update Date | 2016-08-30 |