| NPI | 1992782403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME128535) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: NM MD20050608) |
| 207ZH0000X Pathology Hematology (Licence: NM MD20050608) | |
| 207ZI0100X Pathology Immunopathology (Licence: NM MD20050608) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: NM MD20050608) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2019-01-23 |