| NPI | 1053632299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA A151796) |
| Additional Taxonomies | 207ZC0006X Pathology Clinical Pathology (Licence: CA A151796) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA L-243904) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2024-03-14 |