| NPI | 1316470339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WV 32767) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: WV 32767) |
| 207ZH0000X Pathology Hematology (Licence: WV 32767) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2023-08-04 |