| NPI | 1972690790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA G34975) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: CA G34975) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301062799) | |
| 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: MI 4301062799) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-06-23 |