| NPI | 1750383717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX G8642) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: TX G8642) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2008-02-22 |