| NPI | 1538788807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT227907) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04953) |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2023-06-21 |