| NPI | 1134539984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZH0000X Pathology, Hematology (Licence: MA 286699) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 07651961) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2024-01-05 |