| NPI | 1821404120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: PA MD455614) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: PA MD455614) |
| 207ZH0000X Pathology Hematology (Licence: PA MD455614) | |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2015-07-31 |