| NPI | 1508270778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX U4758) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: LA 305881) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME142758) | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2023-12-07 |