| NPI | 1023336872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: AL 31307) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 62343) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2021-05-18 |