| NPI | 1851503072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX M7603) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: TX M7603) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2009-09-28 |