| NPI | 1154522209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX N5393) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 200834) |
| 207R00000X Internal Medicine (Licence: LA 200834) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2014-08-18 |