| NPI | 1013906874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: VA 0101044472) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: VA 0101044472) |
| 207ZH0000X Pathology Hematology (Licence: VA 0101044472) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: VA 0101044472) | |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: VA 0101044472) | |
| 207ZP0213X Pathology Pediatric Pathology (Licence: VA 0101044472) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2007-07-08 |