| NPI | 1891937140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 982) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 982) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2023-08-10 |