| NPI | 1184902884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME157365) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57019040) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2022-08-23 |