| NPI | 1750689378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A145107) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.018878) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MT203396) | |
| Enumeration Date | 2011-03-06 |
| Last Update Date | 2017-03-17 |