| NPI | 1063457075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA 09179R) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX M2897) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 042172) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2023-04-21 |