| NPI | 1578572400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZH0000X Pathology, Hematology (Licence: NY 180740-1) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 180740-1) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-07-08 |