| NPI | 1912100371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD60226512) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A94118) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2014-12-17 |