| NPI | 1194829721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 35050858) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WV 13835) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2021-08-02 |