| NPI | 1174865638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P7456) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX p7456) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX p7456) | |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2021-04-04 |