| NPI | 1720475874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX S1578) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 55807) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2022-08-10 |