| NPI | 1437325784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 55106) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.011469) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2014-08-25 |