| NPI | 1861979924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: MN 79469) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.245666) |
| Enumeration Date | 2018-07-22 |
| Last Update Date | 2025-06-26 |