| NPI | 1790082550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09474900) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NJ 25MA09474900) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2021-09-21 |