| NPI | 1225475429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MA 4158) |
| Additional Taxonomies | 246QC1000X Spec/Tech, Pathology, Chemistry (Licence: CA 3901) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2021-05-05 |