| NPI | 1649222720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WV 27586) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 11798) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD00046854) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-09-02 |