| NPI | 1316430101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: GA 92177) |
| Additional Taxonomies | 207ZM0300X Pathology Medical Microbiology (Licence: TX T1704) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX BP10063420) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2022-08-19 |