| NPI | 1982196937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT222631) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04296) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2021-06-25 |