| NPI | 1215305792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: ND 16593) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 10822132-1205) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA 145853) | |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2020-10-01 |