| NPI | 1033383351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME107264) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: FL ME107264) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 248122) | |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2020-08-20 |