| NPI | 1760625339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology, Hematology (Licence: WA MD 60318170) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD 60318170) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2021-12-01 |