| NPI | 1720079965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: WA MD60095011) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MN 45419) |
| 207RH0000X Internal Medicine, Hematology (Licence: WA MD60095011) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2012-04-16 |