| NPI | 1780607796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WI 15322-320) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 1020176) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME172793) | |
| 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: MA 1020176) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 65793) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2026-09-03 |