| NPI | 1669413084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NV 10511) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: NV 10511) |
| 207ZH0000X Pathology, Hematology (Licence: NV 10511) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2019-06-12 |