| NPI | 1588630818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: LA 322163) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD065457L) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2020-06-15 |