| NPI | 1306265186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: AZ 73938) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: DC MD20000097) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: DC MD20000097) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2024-09-23 |