| NPI | 1154533412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD60014822) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD60014822) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2018-08-15 |