| NPI | 1346551447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX R2571) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101250631) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2025-02-25 |