| NPI | 1801873617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0104X Pathology Chemical Pathology (Licence: KY 33254) |
| Additional Taxonomies | 207ZM0300X Pathology Medical Microbiology (Licence: KY 33254) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KY 33254) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2012-09-11 |