| NPI | 1164420105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: TX L2619) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: WA MD61092467) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD61092467) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA TD61092468) | |
| 207R00000X Internal Medicine (Licence: WA MD61092467) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2025-10-02 |