| NPI | 1285844092 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX N1640) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-7556) | 
| Enumeration Date | 2007-05-23 | 
| Last Update Date | 2017-08-07 |