| NPI | 1548258833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX G5694) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: TX G5694) |
| 207ZH0000X Pathology Hematology (Licence: TX G5694) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2014-10-30 |