| NPI | 1376500835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AL 32816) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: AL 32816) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 074012) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2019-01-06 |