| NPI | 1811193857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MT MED-PHYS-LIC-52429) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO 49744) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX P3517) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: TX P3517) | |
| 207ZH0000X Pathology, Hematology (Licence: MT MED-PHYS-LIC-52429) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2017-05-06 |