| NPI | 1265815070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY TP335) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: KY TP335) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY R3769) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2020-08-06 |