| NPI | 1093731143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61546122) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD61546122) |
| 207R00000X Internal Medicine (Licence: WA MD61546122) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-05-16 |