| NPI | 1700815602 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: VA 0101257556) | 
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NH 10424) | 
| Enumeration Date | 2006-07-02 | 
| Last Update Date | 2020-10-09 |