| NPI | 1568645950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD442201) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 242539) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME100598) | |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2011-06-01 |