| NPI | 1205178456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX U7632) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2013014793) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2025-02-05 |