| NPI | 1891777686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: WI 3123) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD056634L) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CO 49350) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2023-08-25 |