| NPI | 1013942556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME46694) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: FL ME46694) |
| 207ZH0000X Pathology, Hematology (Licence: FL ME46694) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2015-10-07 |