| NPI | 1629161047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L6958) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 233019) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: TX L6958) | |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2010-09-21 |