| NPI | 1689894495 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX Q3567) | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 63605) | 
| Enumeration Date | 2007-04-26 | 
| Last Update Date | 2022-08-30 |