| NPI | 1144517772 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: TX Q8193) | 
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: MO 2011014923) | 
| Enumeration Date | 2011-07-04 | 
| Last Update Date | 2017-06-13 |