| NPI | 1407262918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WV 29064) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: WV 29064) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301104960) | |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2019-06-10 |