| NPI | 1801063607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 53639) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 230660) |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: MN 53639) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2020-10-06 |