| NPI | 1255321584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME97101) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: FL ME97101) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC 33237) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX K2804) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2023-05-27 |