| NPI | 1306266804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101272850) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: MI 4301502374) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301502374) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2021-02244) | |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2023-02-03 |