| NPI | 1700078342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 2007-01322) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: CT 049879) |
| 207ZH0000X Pathology Hematology (Licence: NJ 25MA08582300) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2024-03-01 |