| NPI | 1720067994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MS 12120) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: MS 12120) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2021-08-02 |