| NPI | 1790913010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: WV 36226) |
| Additional Taxonomies | 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: WV 36226) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WV 36226) | |
| 207ZM0300X Pathology, Medical Microbiology (Licence: WV 36226) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2026-03-30 |