| NPI | 1740222454 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NJ 25MA03065000)  | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2019-02778)  | 
| Enumeration Date | 2006-06-10 | 
| Last Update Date | 2022-06-10 |