| NPI | 1760414189 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0104X Pathology, Chemical Pathology (Licence: VA 0101034577)  | 
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: VA 0101034577)  | 
| Enumeration Date | 2006-07-07 | 
| Last Update Date | 2025-09-11 |