| NPI | 1245289420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A38108) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX G2048) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2010-04-28 |