NPI | 1831297654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35036925) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 10114) |
207RH0000X Internal Medicine, Hematology (Licence: OH 35036925) | |
Enumeration Date | 2006-09-20 |
Last Update Date | 2020-06-05 |