| NPI | 1700909744 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX M1033) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M1033) | 
| Enumeration Date | 2007-04-06 | 
| Last Update Date | 2018-11-09 |