| NPI | 1225057631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61187482) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CO 19508) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-06-24 |