| NPI | 1134231186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX N0972) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NM 2003-0053) |
| 207ZH0000X Pathology, Hematology (Licence: NM 2003-0053) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM 2003-0053) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-03-26 |