| NPI | 1114142064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 61253) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 57.011465) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-10-01 |