| NPI | 1992700611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD00024676) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00024676) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2021-06-16 |