NPI | 1316511157 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX V6260) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM NM2024-0922) |
Enumeration Date | 2021-05-17 |
Last Update Date | 2025-09-03 |