| NPI | 1780625715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 175113) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 175113) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2025-04-29 |