| NPI | 1518220771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX Q3212) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101123456) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2019-11-04 |