| NPI | 1285935585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA A163242) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: CA 136242) |
| 207ZC0006X Pathology Clinical Pathology (Licence: NY 288002) | |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2024-07-10 |