| NPI | 1902008170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: FL ME102349) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: PR 18357) |
| 207ZH0000X Pathology, Hematology (Licence: FL ME102349) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PR 18357) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME102349) | |
| 208D00000X General Practice (Licence: FL ME102349) | |
| 208D00000X General Practice (Licence: PR 18357) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2026-03-04 |