| NPI | 1366655359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: CA A95062) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: CA A95062) |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: CA A95062) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2007-07-08 |