| NPI | 1013159037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SD 10663) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: SD 10663) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2018-03-05 |