NPI | 1689036923 |
---|---|
Former Name | PHILLIP DOUGLAS KNOUSE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 22233-875) |
Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IL 036.149823) |
Enumeration Date | 2016-03-25 |
Last Update Date | 2024-02-28 |