NPI | 1699269753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MT MED-PHYS-LIC-143621) |
Additional Taxonomies | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: WI 75962) |
Enumeration Date | 2018-06-21 |
Last Update Date | 2024-08-06 |