| NPI | 1982895835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD28440) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N3452) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA MD-48903) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2022-10-05 |