| NPI | 1609996057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology Clinical Pathology (Licence: VA 0101233476) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: VA 0101233476) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2019-07-01 |