| NPI | 1619506987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA A193996) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: CA A193996) |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: CA A193996) | |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2025-08-28 |