| NPI | 1972766111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD60460530) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI 5563) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2025-09-22 |