| NPI | 1508220120 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 35.133762)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.027788)  | 
| 207R00000X Internal Medicine (Licence: OH 35.133762)  | |
| Enumeration Date | 2016-04-09 | 
| Last Update Date | 2023-08-07 |