| 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 | 2024-03-05 |