| NPI | 1740251933 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX G5562)  | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME74555)  | 
| Enumeration Date | 2006-01-27 | 
| Last Update Date | 2019-12-13 |