| NPI | 1548752371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA C157996) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 123161) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2019-01-02 |