| NPI | 1902241813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: TX Q9999) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q9999) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2021-12-17 |