| NPI | 1902859630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PR 13238) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: PR 13238) |
| 207ZH0000X Pathology Hematology (Licence: PR 13238) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2016-12-30 |