| NPI | 1073763454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WV TMP-02293) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: WV TMP-02293) |
| 207ZH0000X Pathology, Hematology (Licence: PA MD438141) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD438141) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2023-07-21 |