| NPI | 1609163260 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 34.012685) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OK 5511) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2022-07-21 |