| NPI | 1770677270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NY 92064-1) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: NY 92064-1) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2013-02-12 |