| NPI | 1730241712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 221000) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: NY 221000) |
| 207ZH0000X Pathology, Hematology (Licence: TX M5029) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2024-05-30 |