| NPI | 1356456123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NH RT-1180) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: PA MD431193) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2009-02-18 |