| NPI | 1952689242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: CA A90023) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA A90023) |
| 207RH0000X Internal Medicine Hematology (Licence: CA A90023) | |
| 208D00000X General Practice (Licence: CA A90023) | |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2017-09-11 |