| NPI | 1922022029 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G53026)  | 
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: CA G53026)  | 
| Enumeration Date | 2006-07-26 | 
| Last Update Date | 2008-06-20 |