| NPI | 1063787315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 9355821-1205) |
| Additional Taxonomies | 207RX0202X Internal Medicine Medical Oncology (Licence: UT 9355821-1205) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2021-02-04 |