| NPI | 1972917540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D0091559) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NJ 25MA10547100) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2021-05-20 |