| NPI | 1821235474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61530077) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME145610) |
| 207RH0000X Internal Medicine, Hematology (Licence: FL ME145610) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 87124) | |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: FL ME145610) | |
| Enumeration Date | 2009-01-17 |
| Last Update Date | 2025-06-24 |