| NPI | 1558416826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD60682158) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: NE 22693) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 22693) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2025-04-14 |