| NPI | 1528327210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: UT 11351521-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 57291) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2021-11-11 |