| NPI | 1689397119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: WA TR61317278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA TR61317278) |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2022-09-20 |