| NPI | 1811955818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: FL ME100043) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 054064) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2023-01-19 |