| NPI | 1154696243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 59026) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: AZ 55977) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 55977) | |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2019-04-10 |