| NPI | 1023104528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX M5533) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: LA 023501) |
| 207ZC0500X Pathology, Cytopathology (Licence: TX M5533) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA 023501) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-09-05 |