| NPI | 1639122591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD171696) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00034123) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD00034123) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-07-15 |