| NPI | 1922029875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00015129) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA MD00015129) |
| 207R00000X Internal Medicine (Licence: OR MD25763) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR MD25763) | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2007-07-08 |