| NPI | 1912976770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 005353) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: CO 43915) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO 43915) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2018-03-21 |