| NPI | 1902119019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: OH 35131559) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 56327) |
| Enumeration Date | 2010-07-17 |
| Last Update Date | 2020-12-23 |