| NPI | 1508858812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00043047) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: WA MD00043047) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD00043047) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2007-07-09 |