| NPI | 1245239771 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: DC MD30402) | 
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: DC MD30402) | 
| Enumeration Date | 2005-07-18 | 
| Last Update Date | 2024-04-12 |