| NPI | 1750543989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 55779) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO 2741) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 106088) | |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2012-09-14 |