| NPI | 1558306803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301027663) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MI 4301027663) |
| 207ZD0900X Pathology, Dermatopathology (Licence: MI 4301027663) | |
| 207ZH0000X Pathology, Hematology (Licence: MI 4301027663) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2010-06-17 |