| NPI | 1114136173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX M8852) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10025319) |
| 207R00000X Internal Medicine (Licence: TX M8852) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2009-11-13 |