| NPI | 1407262918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 290712) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: MA 290712) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2026-06-29 |