| NPI | 1053602342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 65944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.018866) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2021-01-25 |