| NPI | 1104815802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX L7702) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L7702) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2021-11-10 |