| NPI | 1194773663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME108622) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: TX L8303) |
| 207ZH0000X Pathology, Hematology (Licence: WI 41115) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX L8303) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 41115) | |
| 207ZH0000X Pathology, Hematology (Licence: FL ME108622) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-06-23 |