| NPI | 1710481288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: MA 1019094) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA 476772) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-04-23 |