| NPI | 1952612038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CT 63980) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 245087) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 284223) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2019-08-21 |