| NPI | 1023237872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX M3182) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: TX M3182) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2015-02-09 |