| NPI | 1487091005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61480163) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NE 30783) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2026-07-27 |