| NPI | 1699768499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: OH 35.061089) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: KY 24614) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2021-04-22 |