| NPI | 1750745360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX R9870) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R9870) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX R9870) | |
| Enumeration Date | 2016-04-09 |
| Last Update Date | 2026-08-26 |