| NPI | 1487094066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: UT 11793611-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 270993) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 270993) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2021-11-02 |