| NPI | 1780954982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NV 17490) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: NV 17490) |
| 207ZH0000X Pathology, Hematology (Licence: NV 17490) | |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2023-04-25 |