| NPI | 1205246394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 53926) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.024870) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2021-05-14 |