| NPI | 1124216643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A105139) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: CA A105139) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: CA 390200000X) | |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2024-03-21 |