| NPI | 1972896413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZH0000X Pathology, Hematology (Licence: TX BP20051991) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX BP1-0040952) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2015-06-12 |