| NPI | 1053343251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN MD15461) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TN MD15461) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 20902) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX G1188) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-03-07 |