| NPI | 1528046976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology Clinical Pathology (Licence: TX K5129) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX K5129) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2022-06-24 |