| NPI | 1760494819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD00045026) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: GA 028953) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2007-07-11 |