| NPI | 1215191929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OK 26551) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: OK 26551) |
| 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: OK 26551) | |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2017-01-23 |