| NPI | 1952567505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 82466) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101247242) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX Q4062) | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2024-07-16 |