| NPI | 1265425078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: OH 35056219) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: KY 33625) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2021-04-22 |