| NPI | 1558322552 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX J0866) | 
| Additional Taxonomies | 207RH0000X Internal Medicine, Hematology (Licence: TX J0866) | 
| Enumeration Date | 2006-03-29 | 
| Last Update Date | 2016-08-06 |