| NPI | 1245291764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: TX G0956) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX G0956) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2007-07-08 |