| NPI | 1902292774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD60783076) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60783076) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2024-01-25 |