| NPI | 1700171691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NJ 25MA08941000) |
| Additional Taxonomies | 193200000X Multi-Specialty (Licence: CA A38872) |
| Enumeration Date | 2011-06-18 |
| Last Update Date | 2020-10-19 |