| NPI | 1639240989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX L8212) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: LA MD201183) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2025-09-11 |