| NPI | 1043950512 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61307458)  | 
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD61307458)  | 
| Enumeration Date | 2022-03-31 | 
| Last Update Date | 2025-07-09 |