| NPI | 1376984807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX T4798) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 285511) |
| 207R00000X Internal Medicine (Licence: NY 285511) | |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2022-09-13 |