| NPI | 1104479203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2026-03462) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MO 2019018934) |
| 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: GA 97756) | |
| 207ZC0006X Pathology, Clinical Pathology (Licence: IL 036-161400) | |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2026-08-18 |