| NPI | 1073822235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: WA MD60707157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10037503) |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: WI 64330) | |
| 207RX0202X Internal Medicine Medical Oncology (Licence: KY 48381) | |
| 207RX0202X Internal Medicine Medical Oncology (Licence: WI 64330) | |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2019-08-07 |