| NPI | 1144859489 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX V5714) | 
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: TX V5714) | 
| 207ZC0006X Pathology, Clinical Pathology (Licence: UT 12404264-1205) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 12404264-1205) | |
| Enumeration Date | 2020-04-08 | 
| Last Update Date | 2025-08-04 |