| NPI | 1407297385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX U9533) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT203125) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2024-06-24 |