| NPI | 1790951325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: GA 072580) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD036088) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 072580) | |
| Enumeration Date | 2008-05-04 |
| Last Update Date | 2018-08-24 |