| NPI | 1790851525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX L8302) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L8302) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 72762) | |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2024-10-08 |