| NPI | 1528499712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OK 38023) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2022-01-10 |