| NPI | 1003182908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: FL 133700) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: FL 1003182908) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2024-01-04 |