| NPI | 1093745846 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MD D30206) | 
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MD D30206) | 
| Enumeration Date | 2006-07-04 | 
| Last Update Date | 2025-09-11 |