| NPI | 1073945143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MT205132) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD460601) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 61858) | |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2019-05-29 |