| NPI | 1366736969 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX R2439) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-9183) | 
| Enumeration Date | 2011-06-01 | 
| Last Update Date | 2018-04-17 |