| NPI | 1619930617 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NJ 25ma04454500) | 
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: PA MD037018E) | 
| Enumeration Date | 2006-04-10 | 
| Last Update Date | 2022-05-09 |