| NPI | 1952408304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD61275401) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: WA MD61275401) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD61275401) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 055450) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-01-19 |