| NPI | 1235295023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WV 17454) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301073051) |
| 207ZH0000X Pathology, Hematology (Licence: WV 17454) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2009-09-29 |