| NPI | 1871655670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: CO DR.0067929) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101242242) |
| 208D00000X General Practice (Licence: VA 0101242242) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2022-06-30 |