| NPI | 1760623557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 87141) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME147802) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2021-01-12 |