| NPI | 1689961484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: TX R0853) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R0853) |
| 207R00000X Internal Medicine (Licence: NE 27582) | |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: NE 27582) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2022-04-08 |