| NPI | 1063703809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD60459476) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60459476) |
| 207RH0000X Internal Medicine, Hematology (Licence: WA MD60459476) | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2019-02-20 |