| NPI | 1295946218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA MD-37888) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57010749) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2011021600) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2014-10-14 |