| NPI | 1104887009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: DE C10012213) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: TX L9076) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX L9076) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD461174) | |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2020-11-16 |