| NPI | 1659614204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME147753) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 82765) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: FL ME147753) | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 62056) | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2023-03-21 |