| NPI | 1639548589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 57.249000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.249000) |
| 363A00000X Physician Assistant (Licence: OH 50.004445) | |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2023-03-21 |