| NPI | 1518926260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: MN 31126) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 31126) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2023-10-11 |