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 |