NPI | 1598939159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA 466778) |
Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 248045) |
207RH0003X Internal Medicine, Hematology & Oncology (Licence: WV 25686) | |
Enumeration Date | 2008-04-15 |
Last Update Date | 2022-10-07 |