| NPI | 1710112453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology Clinical Pathology (Licence: ME DO2584) |
| Additional Taxonomies | 207ZC0006X Pathology Clinical Pathology (Licence: PA OT013153) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2016-12-13 |