| NPI | 1194839399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: GA 27618) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: GA 27618) |
| 207ZH0000X Pathology Hematology (Licence: GA 27618) | |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: GA 27618) | |
| 207ZP0213X Pathology Pediatric Pathology (Licence: GA 27618) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2018-08-31 |