| NPI | 1134474976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61148959) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD61148959) | |
| 207R00000X Internal Medicine (Licence: WA MD61148959) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AR E-11133) | |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2021-04-27 |