| NPI | 1407291610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: LA 310195) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TN 55458) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2018-09-17 |