| NPI | 1861955072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61667941) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 279935) |
| Enumeration Date | 2019-04-13 |
| Last Update Date | 2025-08-12 |