| NPI | 1972729044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OR DO25644) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: WA OP00001715) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2007-07-08 |