| NPI | 1023200540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX R6979) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A144195) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME133558) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2021-12-02 |