| NPI | 1851739668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: OH 35.128141) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 255782) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2021-03-22 |