| NPI | 1962962506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT217727) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD477302) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-01-26 |