| NPI | 1992828073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WI 55409) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: TX C8440) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-05-01 |