| NPI | 1861480857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61048592) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: ID M-15375) |
| 174400000X Specialist (Licence: CA G47070) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: ND LT21604) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA G47070) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2024-09-17 |