| NPI | 1023307154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MD D98396) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: IA MD-44324) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: AR T2016-148) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2023-09-26 |