| NPI | 1275512691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 38455) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: MN 38455) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 38455) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2021-04-27 |