| NPI | 1033410626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: CA G34086) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OH 35302) |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2013-04-09 |