| NPI | 1669035762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T7566) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX T7566) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2025-09-08 |