| NPI | 1578706180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: WI 100760) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: FL ME115099) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2023-06-26 |