| NPI | 1255656120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX 49008) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: UT 8134434-1205) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX 49008) | |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2026-03-12 |