| NPI | 1669675153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME 109094) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: FL ME 109094) |
| 207ZH0000X Pathology, Hematology (Licence: FL ME 109094) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2017-12-05 |