| NPI | 1023083458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA C169718) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 218316) |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2021-04-14 |