| NPI | 1053370874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME54731) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: FL ME54731) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2007-08-25 |