| NPI | 1548258346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NM MD20050718) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: NM MD20050718) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IA 29565) | |
| 207ZH0000X Pathology Hematology (Licence: CA A53441) | |
| 207ZH0000X Pathology Hematology (Licence: IA 29565) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2024-02-16 |