| NPI | 1114198884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: FL ME82004) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MA MC0389507A) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2012-01-13 |