| NPI | 1518301019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 64884) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301102344) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 51219) | |
| 207R00000X Internal Medicine (Licence: OH 129436) | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2025-06-23 |