| NPI | 1750336236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD00037930) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00037930) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2025-07-31 |