| NPI | 1558598110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD60652275) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 241191) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2016-09-22 |