| NPI | 1487220646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: MI 4301515112) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: IA MD-51646) |
| 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: IA MD-51646) | |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2025-10-03 |