| NPI | 1790046787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: CT 73146) |
| Additional Taxonomies | 207SM0001X Medical Genetics, Molecular Genetic Pathology (Licence: CT 73146) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA L-251460) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 269511) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2023-02-07 |