| NPI | 1174577886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 18377) |
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: NE 18377) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-06-23 |