| NPI | 1346321478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 48648) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY TP696) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MI 4301087420) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2023-06-21 |