| NPI | 1497242713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 69855) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 57.246767) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2021-08-02 |