| NPI | 1982795688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0102050262) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: WV WV1825) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WV 1825) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-02-28 |