| NPI | 1801154570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME137863) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: WA 60398177) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2019-03-27 |