| NPI | 1164785291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: LA 330334) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q3389) |
| 207R00000X Internal Medicine (Licence: FL ME124796) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2022-05-11 |