| NPI | 1588685812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: WA MD00046178) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: WA MD00046178) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WA MD00046178) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2025-02-25 |