| NPI | 1629119847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD60750062) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: WA MD60750062) |
| 207ZH0000X Pathology, Hematology (Licence: OK 24466) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OK 24466) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2024-10-31 |