| NPI | 1174587307 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX J8318) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WV 19239) | 
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 191526) | |
| Enumeration Date | 2006-04-14 | 
| Last Update Date | 2024-06-05 |