| NPI | 1053744680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 283309) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MA 283309) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2022-02-07 |