| NPI | 1508088097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SC 83671) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: GA 062213) |
| 207ZH0000X Pathology Hematology (Licence: SC 83671) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: GA 062213) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-11-08 |