| NPI | 1780847665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101263410) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 10030832) |
| 207R00000X Internal Medicine (Licence: TX P1621) | |
| 207R00000X Internal Medicine (Licence: NY 269413) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: SC 39125) | |
| 208000000X Pediatrics (Licence: TX 10030832) | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2018-03-17 |