| NPI | 1467695460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: TX Q3236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2012-00461) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2022-01-20 |