| NPI | 1538347521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: KY 49834) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: IN 01070122A) |
| 207R00000X Internal Medicine (Licence: PA MD433349) | |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2023-07-21 |