| NPI | 1518168442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX R2008) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101236703) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2021-06-28 |