| NPI | 1649564626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 261670) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: MA 261670) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 261670) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2021-01-08 |