| NPI | 1710320866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301114147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD455696) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2021-06-03 |