| NPI | 1023379419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 70766) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: TX R8003) |
| Enumeration Date | 2012-06-03 |
| Last Update Date | 2022-04-06 |