| NPI | 1912024910 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: CA A104041)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A104041)  | 
| 207R00000X Internal Medicine (Licence: TX M1475)  | |
| Enumeration Date | 2007-03-23 | 
| Last Update Date | 2020-11-05 |