| NPI | 1679004915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD193199) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61530844) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A172397) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2025-11-18 |