| NPI | 1083641856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 35-087901) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35087901) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2015-08-14 |