| NPI | 1750871711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61446060) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: WA MD61446060) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2025-02-25 |