| NPI | 1023466539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WV 33745) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: WV 33745) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX T4103) | |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2024-06-07 |