| NPI | 1932455391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 294539-01) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P27647) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD466015) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 294539) | |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2023-07-22 |