| NPI | 1902890908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN MD0000040155) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101046841) |
| 207ZC0500X Pathology, Cytopathology (Licence: VA 0101046841) | |
| 207ZH0000X Pathology, Hematology (Licence: VA 0101046841) | |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2014-07-02 |