| NPI | 1326270992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA 60959822) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT 31990) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MT 31990) | |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2021-06-14 |