| NPI | 1801320031 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: AZ 72827) | 
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: AZ 72827) | 
| Enumeration Date | 2017-04-14 | 
| Last Update Date | 2025-07-15 |