| NPI | 1407047558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD60288034) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 233077) |
| 207ZH0000X Pathology, Hematology (Licence: WA MD60288034) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2013-07-23 |