| NPI | 1851654586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT202477) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT202477) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2018-03-17 |