| NPI | 1154413383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SC 86688) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: SC 86688) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TN 40220) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: GA 047665) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2022-03-01 |