| NPI | 1114997095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SC 21834) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 21834) |
| 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: SC 21834) | |
| 207ZC0500X Pathology Cytopathology (Licence: SC 21834) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2013-08-07 |