| NPI | 1457663676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: LA 310569) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: LA 310569) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2023014492) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2023-06-02 |