| NPI | 1902366677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD61184727) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61184727) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-09-29 |