| NPI | 1851378145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA 304638) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME58840) |
| 207ZH0000X Pathology, Hematology (Licence: FL 58840) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL 58840) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2019-01-29 |