| NPI | 1679554612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: FL ME153747) |
| Additional Taxonomies | 207ZP0007X Pathology Molecular Genetic Pathology (Licence: IA 36220) |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: IA 36220) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2022-01-06 |