| NPI | 1851912034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 1018551) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: MA 1018551) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2025-10-26 |