| NPI | 1760742050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD452072) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT201688) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT201688) | |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2018-01-26 |