| NPI | 1437412590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WA MD61001203) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: PA MD456885) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MT202141) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2020-02-06 |