| NPI | 1922664812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT217546) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT217546) |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2022-06-15 |