| NPI | 1851704415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: GA 89468) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT207422) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2022-01-25 |