| NPI | 1003171976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD60960073) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA R10172) |
| 207R00000X Internal Medicine (Licence: OH 57020645) | |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2020-03-18 |