| NPI | 1619101896 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX P1186) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10034606) | 
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 76457) | |
| Enumeration Date | 2009-05-04 | 
| Last Update Date | 2024-05-31 |