| NPI | 1457354235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.124563) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: AR E4998) |
| 207ZH0000X Pathology, Hematology (Licence: TN 31249) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2017-12-13 |