| NPI | 1023008398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q2258) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX Q2258) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 21230) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX Q2258) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2019-04-16 |