| NPI | 1184685356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX M2380) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: FL ME149215) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2023-01-17 |