| NPI | 1124347760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: NY 284769) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: NY 284769) |
| 207ZC0006X Pathology Clinical Pathology (Licence: NY 284769) | |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2017-03-31 |