Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | MD051516L | PA |
NPI | 1114904323 |
---|---|
Provider Name | Amr Abd-Al-Ghaffar |
First Address | Wenatchee, WA 98801-2974 |
Second Address | Wenatchee, WA 98801-2028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F69223 | (02) | PA |