| NPI | 1669402400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2006006809) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS 04-30948) |
| 207ZH0000X Pathology, Hematology (Licence: KS 04-30948) | |
| 207ZH0000X Pathology, Hematology (Licence: MO 2006006809) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2015-09-28 |