| NPI | 1922000488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX K3278) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AL SP-4) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 80500) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2020-10-05 |