| NPI | 1184044570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61268569) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT205744) |
| 207R00000X Internal Medicine (Licence: WA MD61268569) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A154383) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2022-08-03 |