| NPI | 1588621106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301065761) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: MI 4301065761) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 34950) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2019-01-15 |