| NPI | 1114133584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 11284209-1205) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: VA 0101247166) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: PA MT186091) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2019-06-16 |