| NPI | 1508863838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX L4319) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: TX L4319) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2025-12-02 |