| NPI | 1104085075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: MN 66798) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: WI 54663-020) |
| 207ZC0006X Pathology Clinical Pathology (Licence: WI 54663-020) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2020-12-17 |