| NPI | 1366021081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: OH 57.252211) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 8791-851) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.148462) | |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2024-05-17 |