| NPI | 1285609180 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: DC MD048409)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD071765L)  | 
| 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: DC MD048409)  | |
| Enumeration Date | 2006-02-22 | 
| Last Update Date | 2020-08-03 |