| NPI | 1942286679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: MN 21686) |
| Additional Taxonomies | 174400000X Specialist (Licence: MN 21686) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2017-08-28 |