| NPI | 1568451219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: VA 0101030225) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: VA 0101030225) |
| 207ZH0000X Pathology Hematology (Licence: VA 0101030225) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: VA 0101030225) | |
| 207ZP0104X Pathology Chemical Pathology (Licence: VA 0101030225) | |
| 207ZP0213X Pathology Pediatric Pathology (Licence: VA 0101030225) | |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2007-07-08 |