| NPI | 1942629001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX T3757) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 310206) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2023-03-23 |