| NPI | 1689630063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD60535380) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WI 31875) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2015-03-24 |