| NPI | 1902006190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: PA MD434155) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: MI 4301090465) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2018-12-03 |