| NPI | 1518165943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D69478) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD-429550) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2021-10-01 |