| NPI | 1215371943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA 274974) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: MA 274974) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2018-07-20 |