| NPI | 1023645504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 73994) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MN 73994) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-06-16 |