| NPI | 1942704960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NH 24403) |
| Additional Taxonomies | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: NM MD2022-0338) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2023-08-02 |