| NPI | 1508090473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A172166) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: CA A172166) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61600189) | |
| 207RH0000X Internal Medicine, Hematology (Licence: CA A172166) | |
| 207R00000X Internal Medicine (Licence: CA A172166) | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2026-05-15 |