| NPI | 1740842418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA R-12023) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.246986) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2021-07-09 |