| NPI | 1639412299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD468636) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 5533) |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2019-09-16 |