| NPI | 1477990125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA 20A13264) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: CA 20A13264) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2017-10-12 |