| NPI | 1184018285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX T3827) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T3827) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KY 52720) | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: TX T3827) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2022-08-24 |