| NPI | 1164426524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA OP60102903) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA 20A6222) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2012-05-03 |