| NPI | 1720527864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2022-03036) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: NC 2022-03036) |
| 207ZM0300X Pathology, Medical Microbiology (Licence: NC 2022-03036) | |
| 208D00000X General Practice (Licence: TX T4423) | |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2024-02-20 |