| NPI | 1962457127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL 2405385) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: IL 036-053002) |
| 207ZH0000X Pathology, Hematology (Licence: IL 036-052002) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 036-053002) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2025-09-11 |