| NPI | 1750694675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD166372) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61630669) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2025-02-07 |