| NPI | 1417375957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 53922) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: KY 53922) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2020-08-06 |