| NPI | 1568752954 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD 00019806)  | 
| Additional Taxonomies | 1744R1102X Specialist, Research Study | 
| Enumeration Date | 2011-04-19 | 
| Last Update Date | 2011-04-19 |