| NPI | 1902899214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: OH 35036544) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: KY 19916) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: IN 01026470A) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2015-11-02 |