| NPI | 1710328604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35 128788) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD61502130) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: MI 4301102623) | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2025-10-06 |