| NPI | 1578876371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 127653-1) |
| Additional Taxonomies | 171W00000X Contractor (Licence: NY 127653-1) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2015-06-22 |