| NPI | 1124091475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD08126R) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: LA MD08126R) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2010-06-07 |