| NPI | 1790935153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME 106137) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD432687) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT 183359) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2016-09-27 |