| NPI | 1205817913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 40290) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: MA 40290) |
| 207ZC0500X Pathology, Cytopathology (Licence: MA 40290) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2015-10-19 |