| NPI | 1437192267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NM MD2008-0619) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NM MD2008-0619) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM MD2008-0619) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2022-12-28 |