| NPI | 1992143077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD60759447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60759447) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2020-11-02 |