| NPI | 1639734304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: UT 14126857-1205) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TN 69834) |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2024-09-10 |