| NPI | 1164480612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101233926) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: VA 0101233926) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2015-03-06 |