| NPI | 1578943999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: NY 297952) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IL 125-066986) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2019-06-19 |