| NPI | 1629297320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: CO 51297) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NE 5402) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CO 51297) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CT 61163) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2021-12-28 |