| NPI | 1376031252 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T5001) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: UT 13694985-1205) | 
| Enumeration Date | 2018-04-26 | 
| Last Update Date | 2024-11-20 |