| NPI | 1013297167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX R8326) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT200526) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2018-09-21 |