| NPI | 1891777959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD00039879) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: WA MD00039879) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2012-06-21 |