| NPI | 1790762862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: MN 26917) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MN 26917) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2020-10-06 |