| NPI | 1851896641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 70908) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.140234) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2022-11-18 |