| NPI | 1669612123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX Q9444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD439526) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61358290) | |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2024-09-26 |