| NPI | 1619963543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine Medical Oncology (Licence: WA MD00036160) |
| Additional Taxonomies | 207RH0000X Internal Medicine Hematology (Licence: WA MD00036160) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2022-04-21 |