| NPI | 1629425475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD210377) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61282986) |
| 207R00000X Internal Medicine (Licence: WA MD61282986) | |
| 207R00000X Internal Medicine (Licence: TX S3313) | |
| 207R00000X Internal Medicine (Licence: OR MD210377) | |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2025-11-13 |