| NPI | 1811638547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: UT 14278959-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61570677) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-06-30 |