| NPI | 1679199111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: CA A201166) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: MO 2020018219) |
| Enumeration Date | 2020-06-21 |
| Last Update Date | 2025-05-02 |