| NPI | 1396907275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A103155) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD60095720) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2014-05-08 |