NPI | 1568991297 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD478749) |
Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT222567) |
207R00000X Internal Medicine (Licence: RI MD17002) | |
207R00000X Internal Medicine (Licence: RI LP03927) | |
Enumeration Date | 2017-06-06 |
Last Update Date | 2024-06-26 |