| NPI | 1639361850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 35129769) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301090051) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301090051) | |
| Enumeration Date | 2007-08-11 |
| Last Update Date | 2023-11-03 |