| NPI | 1871654509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 43875) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 43875) |
| 207R00000X Internal Medicine (Licence: GA 43875) | |
| 207R00000X Internal Medicine (Licence: WA MD35540) | |
| 207RH0000X Internal Medicine, Hematology (Licence: WI 3611) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2024-01-09 |