| NPI | 1649405549 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 35-126568)  | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MD D0104120)  | 
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX P3845)  | |
| Enumeration Date | 2009-05-20 | 
| Last Update Date | 2025-06-18 |