| NPI | 1962458877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine Medical Oncology (Licence: WA MD00039975) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00039975) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2013-06-26 |