| NPI | 1457618605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY TP627) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.020948) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 57.020948) | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2025-03-20 |