| NPI | 1760545578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: DE C1 - 0000905) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD - 422640) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2011-10-24 |