| NPI | 1982011375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX P7737) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX p7737) |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2015-06-09 |