| NPI | 1255349494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 33864) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MN 33864) |
| 207ZH0000X Pathology, Hematology (Licence: MN 33864) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2013-10-31 |