| NPI | 1619914355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN MD46916) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NY 339205) |
| 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: TN MD46916) | |
| 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: MA 226122) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2025-08-13 |