| NPI | 1578714424 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX N2606) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N2606) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-10-08 | 
| Last Update Date | 2010-09-16 |