| NPI | 1669765988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 266857) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD450163) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2018-05-09 |