| NPI | 1063858975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: AZ 68286) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: AL 36031) |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2023-09-13 |