| NPI | 1558792788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX S7502) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 276939-1) |
| 207R00000X Internal Medicine (Licence: TX S7502) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NM MD2018-0120) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MS 28664) | |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2024-06-13 |